Acupuncture may help restore impaired homeostasis of the trigeminovascular pain pathway in migraines. In a collaboration between US and Chinese researchers, 100 migraine without aura (MwoA) patients and 46 matched healthy controls (HCs) were recruited. Patients were randomised to four weeks of verum acupuncture, sham acupuncture or a waiting list. HCs had resting state fMRI scans at baseline, while patients underwent scans before and after treatment. Patients received 20 acupuncture sessions over a period of four weeks, using one of three acupuncture protocols (VA1 – Yanglingquan GB-34, Qiuxu GB-40 and Waiguan SJ-5; VA2 – Xiyangguan GB-33, Diwuhui GB-42 and Sanyangluo SJ-8; VA3 – Zusanli ST-36, Chongyang ST-42 and Pianli L.I.-16). Sham acupuncture consisted of needling at non-acupoints. Compared with HCs, MwoA patients showed increased spontaneous activity at rest in several brain regions involved in pain information processing (posterior insula and putamen/caudate). Reduced spontaneous activity at rest was also seen in MwoA patients in brainstem regions connected with input from the trigeminovascular nociceptive pathway (trigeminocervical complex) and output via the descending pain modulatory system (rostral ventromedial medulla). This decreased activity was observed to have normalised after verum (but not sham) acupuncture treatment.

A systematic review by American authors has concluded that acupuncture and electrotherapy can reduce opioid consumption after total knee arthroplasty. Thirty-nine randomised trials (2391 patients), which examined the use of various drug-free interventions (passive motion, preoperative exercise, cryotherapy, electrotherapy and acupuncture), were included in their meta-analysis. Moderate-certainty evidence showed that electrotherapy reduced the use of opioids and that acupuncture delayed opioid use. There was also low-certainty evidence that acupuncture improved pain, based on visual analogue scores. None of the other therapies studied showed any significant effects on either pain or opioid use.

Acupuncture has positive medical, economical and psychological effects for patients suffering from acute burns, according to clinicians working in the Czech Republic. They report retrospective data acquired over three decades from 1008 burn patients who were treated with acupuncture in a hospital surgery ward. The acupuncture points used most often were Lieque LU-7, Hegu L.I.-4, Quchi L.I.-11 and Zusanli ST-36. Usually only one or two needles were used at a time. Acupuncture treatment was observed to lead to analgesia with diminished pain intensity, a more rapid healing process and improvements in final wound healing, with a reduction in reddening, pigmentation and scarring. In addition, systemic reactions such as burn shock were reduced by acupuncture, as was wound infection. Patients treated with acupuncture also required fewer analgesics and sedatives. The best results were achieved when the first acupuncture treatment was applied as soon as possible after the burn injury (ideally immediately, and optimally within 48 hours). The authors also report that these benefits of acupuncture help prevent post-traumatic stress and reduce psychological trauma in burn patients, as well as saving costs by significantly reducing the duration of treatment.

The use of acupuncture in first aid of burns-Clinical report. Burns. 2017 Aug 14. pii: S0305-4179(17)30281-4.

Acupuncture appears to relieve myofascial pain in temporomandibular disorder (TMD) report the Portuguese authors of a systematic review. A total of four randomised trials using acupuncture for TMD treatment were included. Results for acupuncture were observed to be similar to those for treatment with occlusal splints and significantly superior to those for placebo acupuncture.

Acupuncture is an effective and safe treatment for gastro-oesophageal reflux disease (GORD/GERD) according a systematic review by authors from the USA and China. A total of 12 trials involving 1235 patients were included in their meta-analyses, which demonstrated that patients receiving (manual or electro-) acupuncture combined with Western medicine (WM) demonstrated superior global symptom improvement compared with those receiving WM alone. In addition, recurrence rates for those receiving acupuncture alone were found to be lower than those receiving WM alone, while global symptom improvement and symptom scores were similar for both therapies. Acupuncture was also observed to improve quality of life in patients with GORD.

Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis. Acupunct Med 2017;0:1–6.

A feasibility study carried out by a US research team suggests that acupuncture offered in a group setting is effective for reducing pain and depression in patients with chronic pain or osteoarthritis. In a non-randomised, quasi-experimental trial, 113 subjects with chronic pain of the neck, back, shoulder, or osteoarthritis of any region, received eight weekly acupuncture therapy sessions in a group setting. Acupuncture therapy included a combination of acupuncture, tui na, gua sha and auricular treatment. The results showed a statistically and clinically significant decrease in pain severity, pain interference and depression in the study population over eight weeks of treatment. This benefit was sustained through follow up at 24 weeks with no additional intervention. The authors conclude that group acupuncture may be considered an effective treatment option for chronic pain, capable of producing clinically relevant and long-lasting pain reduction, in a setting that potentially improves access for patients of a lower socioeconomic status.

An Israeli research team has found that acupuncture may be able to help clear persistent warts by creating an anti-inflammatory immune response. Eighteen patients with persistent human papilloma virus-caused warts received either verum acupuncture or placebo treatment. Verum acupuncture was performed at Sanyinjiao SP-6, Zhangmen LIV-13, Kongzui LU-6, Zusanli ST-36, Shousanli L.I.-10, Yaoyangguan DU-3 and Zhongwan REN-12. Placebo treatment was performed with non-insertive needling at seven points on the back. Both groups received four treatment sessions, given at one-week intervals. Clinical success was defined as total clearance of all wart lesions with no recurrence for three months. In the treatment group, the clinical success rate was found to be 36.6 per cent, compared with zero per cent in the placebo group. Measurement of cytokine levels in participants’ blood suggested that acupuncture may cause a shift to a Th1–cell-mediated immune response, leading to an anti-inflammatory effect in the immunological microenvironment of the wart lesions, which promotes their resolution.

Investigators from Australia and New Zealand report that acupuncture treatment can reduce menstrual pain intensity, and that its effects can still be felt one year later. A randomised controlled trial was performed with 74 women randomly assigned to one of four treatment arms: low frequency manual acupuncture (LF-MA), high frequency manual acupuncture (HF-MA), low frequency electro-acupuncture (LF-EA) and high frequency electro-acupuncture (HF-EA). A clinical manual-based protocol was used to allow individualised treatment, with a maximum of seven points used per treatment and a total of 12 treatments performed over three menstrual cycles, either once per week (LF groups) or three times per week (HF groups), in the week prior to menstruation. All groups also received a treatment in the first 48 hours of their period. Acupuncture was found to reduce menstrual pain intensity and duration after three months of treatment, and this was sustained for up to one year after the start of the research. The mode of stimulation or frequency of treatment was not found to be significant, although the authors suggest that this may be due to a lack of statistical power. During the treatment period and nine month follow-up all groups showed statistically significant reductions in peak and average menstrual pain compared to baseline, but there were no differences between groups. Health-related quality of life increased significantly in six domains in groups with a high frequency of treatment compared to only two domains in low frequency groups. Manual acupuncture groups required less analgesic medication than electro-acupuncture groups. HF-MA was most effective in reducing secondary menstrual symptoms compared to both-EA groups.

The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial. PLoS One. 2017 Jul 12;12(7):e0180177.

Acupuncture can reduce pain and pathological thickness of the common extensor tendon (CET) in patients with lateral epicondylitis (LE). Ultrasound evaluation of the CET in a patient with LE may reveal increased tendon thickness, which correlates with the severity of the LE. Turkish clinicians randomly assigned 41 patients to acupuncture and control groups. All received conventional treatment, and the acupuncture group also received needling at six acupoints (an ashi point, Shousanli L.I.-10, Quchi L.I.-11, Chize LU-5, Hegu L.I.-4 and Weiguan SJ-5) for 25 minutes per session, two or three times a week for four weeks (a total of 10 sessions). Subjective pain and hand function scores improved in both groups, but pressure pain threshold and CET thickness only improved in the acupuncture group.

An American group has found that acupuncture can significantly and persistently reduce stress in university students and staff. Their study included 111 participants with high self-reported stress levels who either studied or worked at a large urban university. Participants were randomised into a verum or sham acupuncture group, and both groups received treatment once a week for 12 weeks.

The treatment group received needling at a predetermined set of points: Baihui DU-20, Yintang, Shanzhong REN-17, Qihai REN-6, unilateral Shenmen HE-7, Neiguan P-6, Hegu L.I.-4, LIV-3 and Zusanli ST-36, plus auricular points Shen Men, Liver, Point Zero and Heart. The control group received needling without manipulation at three non-acupuncture points. While participants in both groups showed a substantial initial decrease in perceived stress scores, at 12 weeks post-treatment the verum acupuncture group showed a significantly greater treatment effect than the sham group. This study indicates that acupuncture may be successful in decreasing the perception of stress in students and staff at a large urban university, and this effect persists for at least three months after the completion of treatment.

Effectiveness of Acupuncture Therapy on Stress in a Large Urban College Population. J Acupunct Meridian Stud. 2017 Jun;10(3):165-170.